Bone structure coupling systems and methods of use

ABSTRACT

Bone structure coupling devices and methods are provided herein. An example method includes positioning a tubular retraction guide body into a patient, the tubular retraction guide body having two prongs that are positioned in a joint between two adjacent bone structures, creating a hemispherical groove on each of the two adjacent bone structures using a drill bit passed through the tubular retraction guide body, incising out the hemispherical grooves with a broach passed through the tubular retraction guide body, and inserting a graft body having a generally rectangular cross sectional area into the angular grooves to couple the two adjacent bone structures together.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a continuation of and claims the benefit andpriority of U.S. application Ser. No. 15/793,105, filed on Oct. 25,2017, titled “BONE STRUCTURE COUPLING SYSTEMS AND METHODS OF USE” whichis hereby incorporated by reference herein in its entirety, includingall references and appendices cited therein, for all purposes.

FIELD OF THE INVENTION

The present technology pertains to systems and methods for bonestructure coupling or connecting, and more specifically, but not by wayof limitation, to systems and methods that couple or connect two or moreadjacent bone structures, such as adjacent bone structures in asacroiliac joint.

SUMMARY

Various embodiments of the present disclosure are directed to a device,comprising: a graft body comprising a generally rectangular crosssectional area, a first end, and a second end, the graft body comprisinga plurality of rows of teeth; a head extending from the first end of thegraft body; and an adaptor extending from the second end, the adaptorbeing spaced apart from a last of the plurality of rows of teeth to forman inserter device groove, the adaptor terminating with an inserterdevice interface, wherein the inserter device interface is configured tomate with an adaptor interface of an inserter device, wherein theplurality of rows of teeth are oriented so as to prevent migration orejection of the graft body when inserted into a pilot hole created inadjacent bone structures.

Various embodiments of the present disclosure are directed to a method,comprising: positioning a tubular retraction guide body into a patient,the tubular retraction guide body having two prongs that are positionedin a joint between two adjacent bone structures; creating ahemispherical groove on each of the two adjacent bone structures using adrill bit passed through the tubular retraction guide body; incising thehemispherical grooves with a broach passed through the tubularretraction guide body, the broach transforming the hemispherical groovesinto angular grooves; and inserting a graft body having a generallyrectangular cross sectional area into the angular grooves to couple thetwo adjacent bone structures together.

Various embodiments of the present disclosure are directed to a method,comprising: positioning a tubular retraction guide body into a patientbetween two adjacent bone structures separated from one another;creating a pilot hole using a drill bit passed through the tubularretraction guide body, the pilot hole creating a hemispherical groove onouter surfaces of each of the two adjacent bone structures in a singlepass; inserting a graft body having a generally rectangular crosssectional area through the tubular retraction guide and into the pilothole; and driving the graft body into the pilot hole to incise out thehemispherical grooves into angular grooves by rows of cutting teeth onthe graft body, wherein the graft body secures together the two adjacentbone structures.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, where like reference numerals refer toidentical or functionally similar elements throughout the separateviews, together with the detailed description below, are incorporated inand form part of the specification, and serve to further illustrateembodiments of concepts that include the claimed disclosure, and explainvarious principles and advantages of those embodiments.

The methods and systems disclosed herein have been represented whereappropriate by conventional symbols in the drawings, showing only thosespecific details that are pertinent to understanding the embodiments ofthe present disclosure so as not to obscure the disclosure with detailsthat will be readily apparent to those of ordinary skill in the arthaving the benefit of the description herein.

FIG. 1 is a perspective view of a joint finder device constructed inaccordance with the present disclosure.

FIG. 2A is a perspective view of the joint finder device having aT-handle coupled thereto.

FIG. 2B is a perspective view of another joint finder device.

FIG. 3 is a perspective view of a retraction guide constructed inaccordance with the present disclosure.

FIG. 4 is a rear plan view of the retraction guide of FIG. 3 .

FIG. 5 is a perspective view of a drill bit constructed in accordancewith the present disclosure.

FIG. 6 is a perspective view of an example broach device constructed inaccordance with the present disclosure.

FIG. 7 is a close up, perspective view of a incising member of theexample broach device.

FIG. 8 is a front plan view of the incising member of the example broachdevice of FIGS. 6 and 7 .

FIG. 9 is a side elevation view of the incising member of the examplebroach device of FIGS. 6-8 .

FIGS. 10 and 11 are perspective views of an example graft deviceconstructed in accordance with the present disclosure.

FIG. 12 is a perspective view of an example graft inserter deviceconstructed in accordance with the present disclosure.

FIG. 13 is a cross sectional and exploded view of a graft in combinationwith a portion of the example graft inserter device of FIG. 12 .

FIG. 14 is a perspective view of an example impactor device constructedin accordance with the present disclosure.

FIG. 15 is a diagrammatic view of the creation a rectangular pilot holethat receives the graft of FIGS. 10 and 11 , in accordance with thepresent disclosure.

FIG. 16 is a side elevation view of another example graft comprisingboth cutting teeth and gripping teeth.

DETAILED DESCRIPTION

Generally described, the present technology is directed to devices andmethods of use that can be utilized to couple together adjacent bonestructures. For example, the devices disclosed herein can be utilized tofuse or connect adjacent bone structures in a sacroiliac joint. Whilemany examples provided herein will be discussed with reference to thesacroiliac joint for purposes of brevity and clarity, one of ordinaryskill in the art will appreciate that the devices and methods disclosedherein can be utilized for coupling adjacent bone structures in anylocation within a patient. Also, it will be understood that the term‘coupled’ as used herein should be understood to include connection,linkage, fusing, or other similar terminology, as would be appreciatedby one of ordinary skill in the art. Generally, the concept of couplingdescribed herein is related to maintaining two or more bone structuresin mating or close, but spaced apart relationship with one another. Forexample, a mating and/or spaced but close relationship exists betweenthe ilium and sacrum, known as the sacroiliac joint. The coupling of theilium and sacrum is a function of the structure of both bones and howthey interface. This relationship is maintained by a vast network ofligaments and muscles that prevent excessive separation between theilium and sacrum. Excessive separation can occur for a one or more of amyriad of etiologies. The devices and methods of the present disclosureadvantageously restore a proper and/or desired orientation between theiliac and sacrum by fitting one or more grafts inside the sacroiliacjoint that effectively couple the bone structures of the ilium andsacrum. Grafts disclosed herein advantageously resist natural flexion ormovement between the iliac and sacrum while maintaining a desiredorientation between the iliac and sacrum when the iliac and sacrum arein a neutral position.

These and other advantages of the present disclosure will be describedin greater detail below with reference to FIGS. 1-16 .

FIG. 1A is a perspective view of an example finder device 100. Thefinder device 100 comprises a tubular finder body 102 having a first end104 and a second end 106. The tubular finder body 102 comprises apathway 110 extending from an opening 108 in the first end 104 to anopening (not shown) in the second end 106. The pathway 110, in someembodiments, is a cylindrical pathway. The cylindrical pathway receivesa guide rod (not shown) that generally locates a sacroiliac joint (SJ)in a patient. An example representation of a SJ is illustrated in FIG.15 , for example. The guide rod is positioned inside the SJ, and thefinder device 100 is passed over the guide rod.

The second end 106 of the finder device 100 comprises an interface 112that is configured to mate with a T-shaped handle 114, as illustrated inFIG. 2A.

The first end 104 of the finder device 100 comprises finder arms 116 and118. The finder arms 116 and 118 are positioned inside the SJ.

If required, the T-handle 114 functions as a means to drive the finderarms 116 and 118 into the SJ, and also to force the finder arms 116 and118 through any tissues that may exist between the finder arms 116 and118 the SJ, such as ligaments or muscles that overlay the bonestructures. In one or more embodiments, the ends of the finder arms 116and 118, such as end 120 are chiseled to allow the finder arms 116 and118 to dissect through tissue.

FIG. 2B is a perspective view of another example finder device 101. Thisfinder device 101 is similar to the finder device 101 of FIGS. 1A and 2Awith the exception that the tubular finder body 103 has an enlargeddiameter section 105 that is more closely sized to an internal diameterof a retraction guide (see FIGS. 3 and 4 ).

FIG. 3 is a perspective view of an example retraction guide 122 of thepresent disclosure. The retraction guide 122 comprises a retractionguide body 124 that is hollow. The inner diameter of the retractionguide body 124 is sized to allow for the retraction guide 122 to be slidover the finder device 100 (when the T-handle 114) is not coupled to thefinder device 100.

Generally, the retraction guide body 124 comprises a first end 126 and asecond end 128. The first end comprises retraction body arms 130 and132. When the retraction guide 122 is slid over the finder device 100,the retraction body arms 130 and 132 are oriented in parallel with thefinder arms 116 and 118 of the finder device 100. The retraction bodyarms 130 and 132 are then driven into the SJ.

In one or more embodiments, as in FIG. 4 , the second end 128 comprisesa notch 131. The notch 131 provides a groove fabricated into a secondend surface. The notch 131 is used as a guide for receiving a detent(e.g., protrusion) of various other instruments that are guided throughthe retraction guide 122, as will be discussed infra. A portion of thenotch 131 is visible through a window 134 created in a sidewall of theretraction guide body 124. The window 134 provides a view of a positionof an inserted tool. To be sure, each of the tools/devices disclosedherein that are configured to be slidably inserted into the retractionguide 122 can comprise a detent/protrusion as disclosed below.

The retraction guide 122 stays in place inside the SJ while subsequentdevices and methods are utilized in cooperation with the retractionguide body 122.

FIG. 5 is a perspective view of an example drill bit 136. The drill bit136 comprises a drill bit shank 137. The drill bit shank 137 comprises afirst end 138 and a second end 140. A bit 142 is disposed on the firstend 138 and an interface 144 is disposed on the second end 140. Theinterface 144 is configured to engage with a drill. In some embodiments,the tip (e.g., cutting edge) of the drill bit 136 is configured to cutinto the respective bone structures, while the remaining flute and webof the bit 142 create a shaft of the pilot hole.

In some embodiments, the second end 140 comprises a collar 146. Thecollar 146 functions as a stop when the drill bit 136 is placed into theretraction guide body 124. When the drill bit 136 is passed through theretraction guide body 124, the collar 146 will stop when impacting thesecond end surface 133 of the second end 128 of the retraction guidebody 124. A protrusion 135 can be disposed on the drill bit shank 137.

The bit 142 is shaped to create to bore a substantially cylindricalpilot hole in the SJ. The creation of an example cylindrical pilot holeis illustrated with respect to FIG. 15 , which is described in greaterdetail infra.

FIGS. 6-8 collectively illustrate an example broach device 148, for usein accordance with embodiments of the present disclosure. In variousembodiments, the broach device 148 generally comprises a broach body 150with a first end 152 and a second end 154. The second end 154 of thebroach body 150 comprises a handle 156. The handle 156 forms a collar158 at a terminal end thereof. As with other tools, the collar 158limits the translation of the broach device 148 when inserted into theretraction guide 122 (see FIGS. 3 and 4 ).

In more detail, the broach body 150 comprises a substantiallycylindrical portion 160, which transitions into a substantiallyrectangular portion 162. An incising member 164 is disposed at the endof the substantially rectangular portion 162. In some embodiments, aportion of the incising member 164 has a generally rectangular crosssectional area. The cylindrical portion 160 is a generally cylindricalhead that is insertable within the spaced-apart aperture formed by thedrill bit.

While a substantially rectangular portion 162 has been disclosed, anyother geometrical configuration can also likewise be utilized. Ingeneral, the shape of the substantially rectangular portion 162 andincising member 164 correspond to a size and shape of a graft that is tobe placed into the SJ, as will be discussed in greater detail below.

The broach body 150 comprises a protrusion 157 that is configured to fitwithin the notch 131 of the retraction guide 122 (see FIGS. 3 and 4 ).When the broach body 150 is inserted into the retraction guide 122, theprotrusion 157 travels within the notch 131 to ensure proper alignmentof the incising member 164. A proper orientation of the incising member164 will ensure that angular grooves are created in adjacent bonestructures of the SJ.

FIG. 7 is a close-up perspective view of the incising member 164comprises a set of cutting teeth 166 that are substantially similar inshape and size relative to one another. Each of the set of cutting teeth166 has a generally rectangular outer peripheral geometry (see FIG. 8 ).For example, cutting tooth 166A comprises four sides 168A-D. Each rowbehind the cutting tooth 166A is shaped similarly to that of cuttingtooth 166A. Rows 170A-C disposed in front of cutting tooth 166A providea transition between a cylindrical broach tip 172 and the set of cuttingteeth 166 (e.g., rectangular, circumferential cutting teeth).

In general, the cylindrical broach tip 172 is sized to fit into thepilot hole created by the drill bit 136 of FIG. 5 . Cutting tooth 170Ais disposed immediately behind the cylindrical broach tip 172 comprisesfour linear edges 174A-D. In between adjacent ones of the four linearedges 174A-D are arcuate edges 176A-D (e.g., arcuate chamfer). Forexample, arcuate edge 176A is disposed between linear edge 174A andlinear edge 174B. A size of arcuate edges decreases from cutting tooth170A to cutting tooth 170C. This allows for the incising member 164 totransitionally incise out the cylindrical pilot hole created by thedrill bit 136 to create a substantially rectangular pilot hole. Thisprocess is diagrammatically illustrated in FIG. 15 , which is describedin greater detail below.

In sum, the each of the initial set of rows 170A-C has a differentouter-peripheral shape based on its distance from the broach tip 172.The closer a cutting tooth is to the broach tip 172, the larger thearcuate edges are for that cutting tooth.

As best illustrated in FIG. 9 , adjacent cutting teeth are spaced apartfrom one another to create grooves, such as groove 176 that receivesbone fragments when the incising member 164 is driven into thecylindrical pilot hole. These grooves are effectively similar to flutesof a drill bit with the exception that the grooves are not continuous,but individual. In some embodiments, a forwardly adjacent cutting tooth,such as cutting tooth 166A has a tapered and contoured body portion 178that extends toward cutting tooth 166B. This tapered and contoured bodyportion 178 creates a hook-shape for the groove 176.

Once the substantially rectangular pilot hole has been created by thebroach device 148, the substantially rectangular pilot hole is ready toreceive a graft, such as the graft 180 of FIGS. 10 and 11 . Generally,the graft 180 comprises a graft body 182 with a first end 184 and asecond end 186.

In some embodiments, the graft body 182 has a substantially rectangularshape that matches the substantially rectangular pilot hole created asdescribed above. In various embodiments, the first end 184 of the graftbody 182 has a head 188 that comprises a blunt, tapered polygonal sidedhead.

In some embodiments, an adaptor 190 extends from the second end 186. Theadaptor 190 is spaced apart from a last of the plurality of rows ofteeth 192 to form an inserter device groove 194.

The adaptor 190 terminates with an inserter device interface 196. Insome embodiments, the inserter device interface 196 is configured tomate with an adaptor interface of an inserter device, which is describedinfra. In some embodiments, the plurality of rows of teeth 192 areoriented so as to prevent migration or ejection of the graft body 182when inserted into the rectangular pilot hole described above.

In one or more embodiments, the graft body 182 comprises apertures suchas aperture 198 that provide a pathway for the growth of bone when thegraft 180 has been inserted into the substantially rectangular pilothole. In some embodiments, a second aperture 200 is fabricated in adirection that is substantially orthogonal to the aperture 198, allowingfor additional directional bone growth and improved securement of thegraft 180 over time.

The graft 180 is inserted head first into the substantially rectangularpilot hole. Also, the plurality of rows of teeth 192 are oriented in adirection that is opposite of an orientation/direction of the cuttingteeth of the incising member 164 (see FIGS. 6-8 ). This configurationand orientation of the graft 180 ensures that the plurality of rows ofgripping teeth 192 will resist shearing forces (or other forces) thatmight otherwise cause the graft 180 to back out of the substantiallyrectangular pilot hole.

In some embodiments, adjacent teeth, such as tooth 192A and 192B arespaced apart to create a hook-shaped groove 202. The hook-shaped groove202 is formed by an arcuate taper 204 from tooth 192A and lineartransition 206 to tooth 192B.

FIG. 12 illustrates an example inserter device 208. The inserter device208 comprises an inserter body 210 with a first end 212 and a second end214. The second end 214 comprises a collar (e.g., annular stop) 216 andprotrusion 218. The collar 216 acts as a stop that limits thetranslation of the inserter device 208 relative to the retraction guide122.

When the inserter body 210 is inserted into the retraction guide 122,the protrusion 218 travels within the notch 131 of the retraction guide122 to ensure proper alignment of the graft 180 (see FIG. 13 ) relativeto the substantially rectangular pilot hole created by the incisingmember 164 of the broach device 148. The inserter body 210 is sized tobe received within the retraction guide 122.

The first end 212 comprises an adaptor interface 220 that releaseablyretains the graft 180. The adaptor interface 220, in some embodiments,comprises a plurality of resiliently biased tabs (such as tab 222) thatare spaced apart from one another so as to allow for independentmovement. The tab 222 has a configuration that is essentially a negativeprofile of a side of the adaptor 190 of the graft 180.

As best illustrated in FIG. 13 , in some embodiments, each of theplurality of resiliently biased tabs comprises a groove 224 thatreceives one of the plurality of arcuate sidewalls (such as arcuatesidewall 226 of the graft's inserter device interface 196 of the adaptor190. The tab 222 also comprises a detent 228 that engages with theinserter device groove 194 of the graft 180. The adaptor 190 of thegraft 180 is snapped or otherwise engaged into a space formed by theplurality of resiliently biased tabs. The plurality of resilientlybiased tabs deflect to receive the adaptor 190 and clamp around theadaptor 190 based on the shape of the terminal ends of the plurality ofresiliently biased tabs.

In some embodiments, the inserter body 210 is hollow and provides apathway that receives an impactor device 230 as illustrated in FIG. 14 .FIG. 14 is a perspective view of an example impactor device 230 that canbe inserted through a pathway in the inserter body 210. The impactordevice 230 includes a shaft 232 with a terminal end that contacts theadaptor 190 of the graft 180. An opposing end of the impactor device 230can be impacted to drive the graft 180 into the SJ.

FIG. 15 is a diagrammatic representation of a portion of a sacroiliacjoint SJ formed between adjacent bone structures 234 and 236, with bonestructure 234 being a sacrum and bone structure 236 being an ilium.Again, this technology is adaptable for use in any joint where bonestructures are located in proximate but spaced apart-relationship. Thepresent disclosure can also be utilized in instances where adjacent bonestructures are contacting one another. In these instances, the finderand retraction guide disclosed above can be inserted between thecontacting adjacent bone structures.

The following description presents an example use case and method forsecuring the bone structures 234 and 236 using the device(s) of FIGS.1A-14 . Thus, FIGS. 1-15 are collectively referred to in the followingsections.

In some embodiments, a space 238 exists between the adjacent bonestructures 234 and 236. Although not shown, as noted above, the finderdevice 100 and retraction guide 122 have their respective arms placedinto the space 238. For example, the retraction body arms 130 and 132 ofthe retraction guide 122 are located in the space 238. This allows apathway of the retraction guide 122 to be position partially over thebone structure 234 and the bone structure 236.

When the drill bit 136 (see FIG. 5 ) is passed through the retractionguide 122 sections of the bone structures 234 and 236 are drilled out.For example, section 240 and section 242 are drilled out to createhemispherical grooves 244 and 246 at the same time. That is, the drillbit creates both grooves in a single pass.

These hemispherical grooves are produced when the drill bit passes intoand/or transversely over the outer facing surfaces of the adjacent bonestructures 234 and 236. That is, the view of the SJ in FIG. 15 is a topdown view of the adjacent bone structures 234 and 236 where the drillpassed downwardly and transversely across the outer facing surfaces ofthe bone structures to create an aperture 248. In some embodiments, aspaced-apart aperture is created due to the space 238 that existsbetween the two adjacent bone structures 234 and 236. Again, the drillbit creates a substantially cylindrical pilot hole (e.g., aperture 248).To be sure, when the adjacent bone structures are contacting oneanother, the pilot hole or aperture created may not have a spaced-apartappearance or configuration. This device is also capable of being usedin a solid bone structure as well, where no joint exists.

The dotted line diamond pattern 250 indicates a desired peripheral shapefor a rectangular pilot hole that will be created when the spaced-apartaperture 248 is created using the broach device 148 described above.

In more detail, the incising member 164 of the broach device 148 islocated on the pilot hole 248 by inserting the cylindrical broach tip172 into the pilot hole 248. The broach device 148 is driven into thepilot hole 248 causing the incising member 164 to advance downwardlyinto the pilot hole 248. In some embodiments, the initial rows of teeth(cutting teeth 170A-C) of the incising member 164 begin to convert thepilot hole 248 into a rectangular pilot hole 252. The shape andconfiguration of the cutting teeth of the incising member 164 provide atransition between the cylindrical broach tip 172 and the cutting teeth166, which have a rectangular outer peripheral geometry.

The incising member 164 converts the hemispherical grooves 244 and 246into angular grooves 254 and 256. In some embodiments a vertex of eachof the angular grooves 254 and 256 is approximately orthogonal to asurface of a bone structure. For example, vertex 258 is orthogonal to aplane X that is perpendicular to an outer surface of the bone structure234.

Next, the graft 180 is positioned at the end of an inserter device (suchas the one described above) and is guided downwardly into therectangular pilot hole 252 through translation of the inserter devicethrough the retraction guide. An impactor device can be used to seatand/or drive the graft 180 into the rectangular pilot hole 252. Thegraft 180 is driven into the rectangular pilot hole 252 in a head-firstorientation, which ensures that the plurality of rows of teeth 192 ofthe graft 180 (see FIGS. 10 and 11 ) engage with the surfaces of theadjacent bone structures 234 and 236, seating the graft 180 in a securemanner. In general, the plurality of rows of teeth are oriented so as toprevent migration or ejection of the graft body when inserted into apilot hole created in adjacent bone structures. Over time, the aperturesfabricated into the graft body of the graft will begin to fill with bonematerial and increase the structural integrity of the connection betweenthe adjacent bone structures. That is, installation of the graft 180will connect, couple, fuse, or otherwise joint together the adjacentbone structures.

In sum, the process described above generally includes a step ofpositioning a tubular retraction guide body into a patient. The tubularretraction guide body has two prongs or arms that are positioned in ajoint between two adjacent bone structures. Next, the method includescreating a hemispherical groove on each of the two adjacent bonestructures using a drill bit passed through the tubular retraction guidebody. In some embodiments, the method includes incising thehemispherical grooves with a broach passed through the tubularretraction guide body. The broach transforms the hemispherical groovesinto angular grooves. Finally, the method includes inserting a graftbody having a generally rectangular cross sectional area into theangular grooves to couple the two adjacent bone structures together.

It will be understood that multiple grafts can be installed along the SJusing the methods described above.

FIG. 16 illustrates another example graft 300 that is similar inconstruction to the graft 180 of FIGS. 10 and 11 with the exception thatinstead of comprising only gripping teeth; the graft 300 comprises bothcutting/incising teeth and gripping teeth.

In some embodiments, a graft body 302 of the graft 300 is provided witha first end 304 and a second end 306. The first end 304 comprises a headwith rectangular sides. The second end comprises an inserter interfacethat cooperates with an inserter device as described above.

In one or more embodiments, the graft body 302 comprises an aperture 308that provides a pathway for bone growth through the graft body 302. Invarious embodiments, the graft body comprises a set of cutting teeth 310adjacent to a set of gripping teeth 312. The set of cutting teeth 310are oriented in a direction that is opposite of the set of grippingteeth 312. Each of the rows of teeth (whether cutting or gripping) formsa groove with adjacent teeth. These grooves fill with bone material whenthe graft is inserted into a pilot hole in a joint.

In general the first portion of the plurality of rows of teeth (cuttingteeth 310) are configured to remove bone as the graft body is insertedinto the pilot hole, the second portion of the plurality of rows ofteeth being configured to prevent retraction of the graft body fromdisengaging from the bone

Advantageously, the use of the graft 300 reduces the need to use abroach device, as described above, in order to convert a cylindricalpilot hole into a rectangular pilot hole. In more detail, after acylindrical pilot hole is created, the graft 300 is inserted into thecylindrical pilot hole and driven into the pilot hole to join adjacentbone structures together. The set of cutting teeth 310 remove bone fromthe hemispherical grooves of the cylindrical pilot hole, converting thesame into a rectangular pilot hole with angular grooves (see FIG. 15 ).In sum, the graft 300 functions as both a broach and a graft.

Although not shown, the first end 304 and the set of cutting teeth 310of the graft 300 can be replaced with the cylindrical broach tip 172 andinitial cutting teeth 170A-C of the incising member 164 of the broachdevice 148 (see FIG. 6 ).

A method for using the graft 300 includes, for example, positioning atubular retraction guide body into a patient between two adjacent bonestructures separated from one another. This can include the use of thefinder device, in some embodiments.

Next, the method includes creating a pilot hole using a drill bit passedthrough the tubular retraction guide body. As noted above, the pilothole creates a hemispherical groove on outer surfaces of each of the twoadjacent bone structures in a single pass.

In some embodiments, the method includes a step of inserting a graftbody having a generally rectangular cross sectional area through thetubular retraction guide and into the pilot hole. The method alsoincludes driving the graft body into the pilot hole to incise thehemispherical grooves into angular grooves by rows of cutting teeth onthe graft body. To be sure, the graft body secures together the twoadjacent bone structures into which the hemispherical grooves weredrilled. Again, the rectangular pilot hole is created when cutting teethdisposed in proximity to the head of the graft incise out bone materialfrom the hemispherical grooves.

The corresponding structures, materials, acts, and equivalents of allmeans or step plus function elements in the claims below are intended toinclude any structure, material, or act for performing the function incombination with other claimed elements as specifically claimed. Thedescription of the present technology has been presented for purposes ofillustration and description, but is not intended to be exhaustive orlimited to the present technology in the form disclosed. Manymodifications and variations will be apparent to those of ordinary skillin the art without departing from the scope and spirit of the presenttechnology. Exemplary embodiments were chosen and described in order tobest explain the principles of the present technology and its practicalapplication, and to enable others of ordinary skill in the art tounderstand the present technology for various embodiments with variousmodifications as are suited to the particular use contemplated.

Aspects of the present technology are described above with reference toflowchart illustrations and/or block diagrams of methods, apparatus(systems) and computer program products according to embodiments of thepresent technology. It will be understood that each block of theflowchart illustrations and/or block diagrams, and combinations ofblocks in the flowchart illustrations and/or block diagrams, can beimplemented by computer program instructions.

In the following description, for purposes of explanation and notlimitation, specific details are set forth, such as particularembodiments, procedures, techniques, etc. in order to provide a thoroughunderstanding of the present invention. However, it will be apparent toone skilled in the art that the present invention may be practiced inother embodiments that depart from these specific details.

Reference throughout this specification to “one embodiment” or “anembodiment” means that a particular feature, structure, orcharacteristic described in connection with the embodiment is includedin at least one embodiment of the present invention. Thus, theappearances of the phrases “in one embodiment” or “in an embodiment” or“according to one embodiment” (or other phrases having similar import)at various places throughout this specification are not necessarily allreferring to the same embodiment. Furthermore, the particular features,structures, or characteristics may be combined in any suitable manner inone or more embodiments. Furthermore, depending on the context ofdiscussion herein, a singular term may include its plural forms and aplural term may include its singular form. Similarly, a hyphenated term(e.g., “on-demand”) may be occasionally interchangeably used with itsnon-hyphenated version (e.g., “on demand”), a capitalized entry (e.g.,“Software”) may be interchangeably used with its non-capitalized version(e.g., “software”), a plural term may be indicated with or without anapostrophe (e.g., PE's or PEs), and an italicized term (e.g., “N+1”) maybe interchangeably used with its non-italicized version (e.g., “N+1”).Such occasional interchangeable uses shall not be consideredinconsistent with each other.

Also, some embodiments may be described in terms of “means for”performing a task or set of tasks. It will be understood that a “meansfor” may be expressed herein in terms of a structure, such as aprocessor, a memory, an I/O device such as a camera, or combinationsthereof. Alternatively, the “means for” may include an algorithm that isdescriptive of a function or method step, while in yet other embodimentsthe “means for” is expressed in terms of a mathematical formula, prose,or as a flow chart or signal diagram.

The terminology used herein is for the purpose of describing particularembodiments only and is not intended to be limiting of the invention. Asused herein, the singular forms “a”, “an” and “the” are intended toinclude the plural forms as well, unless the context clearly indicatesotherwise. It will be further understood that the terms “comprises”and/or “comprising,” when used in this specification, specify thepresence of stated features, integers, steps, operations, elements,and/or components, but do not preclude the presence or addition of oneor more other features, integers, steps, operations, elements,components, and/or groups thereof.

It is noted at the outset that the terms “coupled,” “connected”,“connecting,” “electrically connected,” etc., are used interchangeablyherein to generally refer to the condition of beingelectrically/electronically connected. Similarly, a first entity isconsidered to be in “communication” with a second entity (or entities)when the first entity electrically sends and/or receives (whetherthrough wireline or wireless means) information signals (whethercontaining data information or non-data/control information) to thesecond entity regardless of the type (analog or digital) of thosesignals. It is further noted that various figures (including componentdiagrams) shown and discussed herein are for illustrative purpose only,and are not drawn to scale.

If any disclosures are incorporated herein by reference and suchincorporated disclosures conflict in part and/or in whole with thepresent disclosure, then to the extent of conflict, and/or broaderdisclosure, and/or broader definition of terms, the present disclosurecontrols. If such incorporated disclosures conflict in part and/or inwhole with one another, then to the extent of conflict, the later-dateddisclosure controls.

The terminology used herein can imply direct or indirect, full orpartial, temporary or permanent, immediate or delayed, synchronous orasynchronous, action or inaction. For example, when an element isreferred to as being “on,” “connected” or “coupled” to another element,then the element can be directly on, connected or coupled to the otherelement and/or intervening elements may be present, including indirectand/or direct variants. In contrast, when an element is referred to asbeing “directly connected” or “directly coupled” to another element,there are no intervening elements present.

Although the terms first, second, etc. may be used herein to describevarious elements, components, regions, layers and/or sections, theseelements, components, regions, layers and/or sections should notnecessarily be limited by such terms. These terms are only used todistinguish one element, component, region, layer or section fromanother element, component, region, layer or section. Thus, a firstelement, component, region, layer or section discussed below could betermed a second element, component, region, layer or section withoutdeparting from the teachings of the present disclosure.

The terminology used herein is for the purpose of describing particularembodiments only and is not intended to be necessarily limiting of thedisclosure. As used herein, the singular forms “a,” “an” and “the” areintended to include the plural forms as well, unless the context clearlyindicates otherwise. The terms “comprises,” “includes” and/or“comprising,” “including” when used in this specification, specify thepresence of stated features, integers, steps, operations, elements,and/or components, but do not preclude the presence or addition of oneor more other features, integers, steps, operations, elements,components, and/or groups thereof.

Example embodiments of the present disclosure are described herein withreference to illustrations of idealized embodiments (and intermediatestructures) of the present disclosure. As such, variations from theshapes of the illustrations as a result, for example, of manufacturingtechniques and/or tolerances, are to be expected. Thus, the exampleembodiments of the present disclosure should not be construed asnecessarily limited to the particular shapes of regions illustratedherein, but are to include deviations in shapes that result, forexample, from manufacturing.

Any and/or all elements, as disclosed herein, can be formed from a same,structurally continuous piece, such as being unitary, and/or beseparately manufactured and/or connected, such as being an assemblyand/or modules. Any and/or all elements, as disclosed herein, can bemanufactured via any manufacturing processes, whether additivemanufacturing, subtractive manufacturing and/or other any other types ofmanufacturing. For example, some manufacturing processes include threedimensional (3D) printing, laser cutting, computer numerical control(CNC) routing, milling, pressing, stamping, vacuum forming,hydroforming, injection molding, lithography and/or others.

Any and/or all elements, as disclosed herein, can include, whetherpartially and/or fully, a solid, including a metal, a mineral, aceramic, an amorphous solid, such as glass, a glass ceramic, an organicsolid, such as wood and/or a polymer, such as rubber, a compositematerial, a semiconductor, a nano-material, a biomaterial and/or anycombinations thereof. Any and/or all elements, as disclosed herein, caninclude, whether partially and/or fully, a coating, including aninformational coating, such as ink, an adhesive coating, a melt-adhesivecoating, such as vacuum seal and/or heat seal, a release coating, suchas tape liner, a low surface energy coating, an optical coating, such asfor tint, color, hue, saturation, tone, shade, transparency,translucency, non-transparency, luminescence, anti-reflection and/orholographic, a photo-sensitive coating, an electronic and/or thermalproperty coating, such as for passivity, insulation, resistance orconduction, a magnetic coating, a water-resistant and/or waterproofcoating, a scent coating and/or any combinations thereof.

Unless otherwise defined, all terms (including technical and scientificterms) used herein have the same meaning as commonly understood by oneof ordinary skill in the art to which this disclosure belongs. Theterms, such as those defined in commonly used dictionaries, should beinterpreted as having a meaning that is consistent with their meaning inthe context of the relevant art and should not be interpreted in anidealized and/or overly formal sense unless expressly so defined herein.

Furthermore, relative terms such as “below,” “lower,” “above,” and“upper” may be used herein to describe one element's relationship toanother element as illustrated in the accompanying drawings. Suchrelative terms are intended to encompass different orientations ofillustrated technologies in addition to the orientation depicted in theaccompanying drawings. For example, if a device in the accompanyingdrawings is turned over, then the elements described as being on the“lower” side of other elements would then be oriented on “upper” sidesof the other elements. Similarly, if the device in one of the figures isturned over, elements described as “below” or “beneath” other elementswould then be oriented “above” the other elements. Therefore, theexample terms “below” and “lower” can, therefore, encompass both anorientation of above and below.

While various embodiments have been described above, it should beunderstood that they have been presented by way of example only, and notlimitation. The descriptions are not intended to limit the scope of theinvention to the particular forms set forth herein. To the contrary, thepresent descriptions are intended to cover such alternatives,modifications, and equivalents as may be included within the spirit andscope of the invention as defined by the appended claims and otherwiseappreciated by one of ordinary skill in the art. Thus, the breadth andscope of a preferred embodiment should not be limited by any of theabove-described exemplary embodiments.

What is claimed is:
 1. A device, comprising: a graft body comprising agenerally rectangular cross sectional area, a first end, and a secondend, the graft body comprising a plurality of rows of teeth; a headextending from the first end of the graft body; and an adaptor extendingfrom the second end, the adaptor being spaced apart from a last of theplurality of rows of teeth to form an inserter device groove, theadaptor terminating with an inserter device interface, wherein theinserter device interface is configured to mate with an adaptorinterface of an inserter device, wherein the plurality of rows of teethare oriented so as to prevent migration or ejection of the graft bodywhen inserted into a pilot hole created in adjacent bone structures. 2.The device according to claim 1, wherein the graft body comprises one ormore apertures that provide a pathway for bone growth through the graftbody.
 3. The device according to claim 1, wherein a first portion of theplurality of rows of teeth are oriented in a first direction and asecond portion of the plurality of rows of teeth are oriented in asecond direction that is opposite of the first direction, the firstportion of the plurality of rows of teeth being configured to removebone as the graft body is inserted into the pilot hole, the secondportion of the plurality of rows of teeth being configured to preventretraction of the graft body from disengaging from the bone.
 4. Thedevice according to claim 1, wherein the inserter device interfacecomprises a plurality of arcuate shaped sidewalls that form aprotrusion.
 5. The device according to claim 4, further comprising theinserter device, wherein the inserted device comprises: the inserterdevice body having a first end and a second end; and the first endcomprising the adaptor interface, the adaptor interface comprising: aplurality of resiliently biased tabs that are spaced apart from oneanother so as to allow for independent movement; and wherein each of theplurality of resiliently biased tabs comprises: a groove that receivesone of the plurality of arcuate sidewalls of the inserter deviceinterface of the adaptor; and a detent that engages with the inserterdevice groove of the graft.
 6. The device according to claim 5, whereinthe second end of the inserter device comprises an annular stop.
 7. Thedevice according to claim 6, further comprising a retraction guide thatcomprises a tubular retraction guide body having an inner sidewallsurface, the retraction guide body having two prongs that arepositionable in a space between two adjacent bone structures.
 8. Thedevice according to claim 7, further comprising a drill bit that isconfigured to create a hemispherical groove on each of the two adjacentbone structures with one pass, wherein the hemispherical grooves form aspaced-apart aperture based on a joint space that exists between the twoadjacent bone structures.
 9. The device according to claim 8, furthercomprising a broach comprising: a broach body having a first end and asecond end; a broach tip disposed on the first end of the broach body,the broach tip comprising a generally cylindrical head that isconfigured to insert within the spaced-apart aperture formed by thedrill bit; and an incising member comprising a plurality of rectangular,circumferential cutting teeth positioned behind the generallycylindrical head, the plurality of rectangular circumferential cuttingteeth incise out the hemispherical grooves to create an angular grooves,each with a vertex.
 10. The device according to claim 9, wherein thevertex is approximately orthogonal to a surface of a bone structure. 11.The device according to claim 9, wherein the plurality of rectangular,circumferential cutting teeth comprise an initial set rectangular,circumferential cutting teeth that are proximate the broach tip, each ofthe initial set comprising four surfaces, wherein each corner of wherethe four surfaces meet comprise an arcuate chamfered edge.
 12. Thedevice according to claim 9, wherein each of the initial set increasesin outer-peripheral area based on a distance from the broach tip. 13.The device according to claim 1, further wherein the head is blunt,tapered polygonal sided head.
 14. A method, comprising: positioning atubular retraction guide body into a patient, the tubular retractionguide body having two prongs that are positioned in a joint between twoadjacent bone structures; creating a hemispherical groove on each of thetwo adjacent bone structures using a drill bit passed through thetubular retraction guide body; incising the hemispherical grooves with abroach passed through the tubular retraction guide body, the broachtransforming the hemispherical grooves into angular grooves; andinserting a graft body having a generally rectangular cross sectionalarea into the angular grooves to couple the two adjacent bone structurestogether.
 15. The method according to claim 14, further comprisingpassing the drill bit transversely over outer facing surfaces of the twoadjacent bone structures at the same time.
 16. The method according toclaim 14, further comprising inserting the graft body into thehemispherical groove by passing an inserter through the tubularretraction guide body, the graft body being secured on a terminal end ofthe inserter in a selectively removable manner.
 17. The method accordingto claim 16, further comprising driving the graft body into thehemispherical grooves to incise the hemispherical grooves into angulargrooves by way of cutting teeth on the graft body.
 18. The methodaccording to claim 14, further comprising inserting packing materialinto a space created during incising prior to inserting the graft body.19. A method, comprising: positioning a tubular retraction guide bodyinto a patient between two adjacent bone structures separated from oneanother; creating a pilot hole using a drill bit passed through thetubular retraction guide body, the pilot hole creating a hemisphericalgroove on outer surfaces of each of the two adjacent bone structures ina single pass; inserting a graft body having a generally rectangularcross sectional area through the tubular retraction guide and into thepilot hole; and driving the graft body into the pilot hole to incise thehemispherical grooves into angular grooves by rows of cutting teeth onthe graft body, wherein the graft body secures together the two adjacentbone structures.